老人健康檢查族群其健康識能之相關因素研究─以台北市某醫學中心為例

Health Literacy and Related Factors in Elderly Health Check-up Examinees in a Medical Center in Taipei City

目的：具備足夠的健康識能(health literacy)，可幫助長者確實掌管自己健康，並為自己的健康做最適切的決定。研究指出，健康識能不足長者與較差健康結果之間有顯著相關性，且健康識能不足亦影響規則服藥遵從性。因此，長者健康識能是否良好，將影響其老年健康狀況及相關醫療預後。目前尚無老人健康檢查受檢者其健康識能現狀及相關影響因素的研究，因此，本研究以接受老人健康檢查的長者為對象，調查其健康識能現況，評估其對自我健康狀況的影響，並了解影響健康識能的因素。

方法：本研究為橫斷性研究，以便利取樣方式，自2018年4月至12月至某醫學中心接受老人健康檢查的民眾，年齡65歲以上共67位納入。研究對象接受臺北市老人健康檢查項目，並施行健康識能量表篩檢，使用複線性迴歸進行各種危險因子與健康識能的相關性探討。

結果：研究結果發現，健康識能與AD-8量表（ascertain dementia 8, 極早期失智症篩檢量表）的結果為顯著的負相關，AD-8量表每增加1分，健康識能則降低4.84分(β=-4.84, 95% CI: -8.28, -1.41; p=0.006)；健康識能分數隨著年齡增加而降低(β=-0.36, 95% CI: -0.71, -0.02; p=0.02)，隨著教育程度越高(β=2.24, 95% CI: 1.34, 3.15; p<0.001)、體重增加(β=0.87, 95% CI: 0.40, 1.35; p=0.001)而增加，但隨著腰圍(β=-0.74, 95% CI: -1.25, -0.23; p=0.009)、舒張壓(β=-0.14, 95% CI: -0.26, -0.01; p=0.03)及高密度脂蛋白膽固醇(β=-0.22, 95% CI: -0.36, -0.08; p=0.003)增加而降低。

結論：研究發現，非侵入式的AD-8量表分數、年齡、教育程度、體重、腰圍及舒張壓是健康識能程度高低的相關因子，未來可利用這些因子初步辨認長者的健康識能程度，並針對不同程度予以不同之衛教方式及健康促進活動，作為設計預防保健、疾病防治策略之工具。

 

Purpose: An adequate level of health literary is crucial for the elderly to practice better disease management and improve quality of life. On the other hand, limited health literacy has been linked to poor health and medication adherence. Older people with limited health literacy tend to suffer a steeper medical cost and poorer quality of life and health status. To address these concerns, the study aimed at exploring the associations between health literacy and the domains of health examination results in elderly check-up examinees by investigating key sociodemographic and clinical variables as related factors.

Methods: A cross-sectional study was conducted on adults (n=67; aged 65 years and over) taking elderly health examinations elderly, in a medical center in Taipei, Taiwan. Participants completed health literacy tests and health examinations. Multivariate linear regressions were performed to examine the associations between health literacy and results of examination.

Results: Health literary was observed to have a significant negative association with AD-8 (Ascertain Dementia 8) score with a one-point rise in the AD-8 score triggering a 4.84-point decrease in the health literary score (β=-4.84, 95% CI: -8.28, -1.41; p=0.006). Health literacy appeared to decline with age (β=-0.36, 95% CI: -0.71, -0.02; p=0.02), waist circumference (β=- 0.74, 95% CI: -1.25, -0.23; p=0.009), diastolic blood pressure (β=-0.14, 95% CI: -0.26, -0.01; p=0.03), and values of HDL-cholesterol (β=-0.22, 95% CI: -0.36, -0.08; p=0.003); on the other hand, health literary increased with education level (β=2.24, 95% CI: 1.34, 3.15; p<0.001) and body weight (β=0.87, 95% CI: 0.40, 1.35; p=0.001).

Conclusion: Taking into consideration factors like AD-8 score, age, education level, body weight, waist circumference, or blood pressure can be expected to help measure the health literary levels of elderly patients for the development of more effective health promotion interventions and care plans.